Diagnostic usefulness of plexus magnetic resonance imaging in chronic inflammatory demyelinating polyradiculopathy without electrodiagnostic criteria of demyelination
| Autor: | Céline Labeyrie, Jean-Marc Léger, M.‐A. Labeyrie, David Adams, R. Costa, Guillaume Fargeot, Christophe Vandendries, Karine Viala, Marie Théaudin |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Contrast enhancement Neural Conduction Expert committee 03 medical and health sciences 0302 clinical medicine Peripheral nerve medicine Humans 030212 general & internal medicine Peripheral Nerves Aged Retrospective Studies Plexus medicine.diagnostic_test business.industry Magnetic resonance neurography Reproducibility of Results Magnetic resonance imaging Middle Aged Polyradiculopathy Magnetic Resonance Imaging Neurology Polyradiculoneuropathy Chronic Inflammatory Demyelinating Female Neurology (clinical) Radiology business 030217 neurology & neurosurgery Mri findings |
| Zdroj: | European journal of neurology. 26(4) |
| ISSN: | 1468-1331 |
| Popis: | BACKGROUND AND PURPOSE The usefulness of plexus magnetic resonance imaging (MRI) in the diagnosis of chronic inflammatory demyelinating polyradiculopathy (CIDP) without definite European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria is currently unclear. METHODS Data from consecutive patients with clinical manifestations suggesting CIDP, with or without (CIDP-D and CIDP-ND, respectively) definite EFNS/PNS electrodiagnostic criteria, and referred for plexus MRI in our imaging centre were retrospectively analysed. An expert committee of neurologists compared the level of suspicion of CIDP in CIDP-ND patients to the blinded/unblinded MRI findings. Plexus MRI was reviewed by a neuroradiologist blinded to the final diagnosis. RESULTS In all, 38 patients were assessed with suspected CIDP-ND [7/38 (18%) probable; 13/38 (34%) possible; 18/38 (47%), no EFNS/PNS electrodiagnostic criteria], plus 10 with CIDP-D. Thirty-six of the 38 (95%) fulfilled clinical criteria of CIDP variants, including pure sensory neuropathy in 22/36 (61%). Plexus MRI showed abnormalities in 22/38 (58%) patients including increased nerve signal intensity on T2-weighted images in 22/22 (100%), nerve enlargement in 20/22 (91%) and contrast enhancement in 8/22 (36%). Plexus MRI enabled the expert committee's final diagnosis to be adjusted in 7/38 (18%) patients, and in conjunction with nerve conduction studies was a supportive criterion to classify 7/24 (29%) patients as definite CIDP. MRI abnormalities were more asymmetrical (P = 0.03) and less diffuse (P = 0.1) in CIDP-ND than in CIDP-D. CONCLUSIONS Our observations suggest that plexus MRI makes a valuable contribution to the diagnosis of CIDP-ND patients. Further studies are needed to investigate inter-rater reliability of clinical and imaging criteria of CIDP in these patients, and the impact on outcomes. |
| Databáze: | OpenAIRE |
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